1. The most recent Cholera pandemic

a) ended in 1830
b) ended in 1854
c) ended in 1892
d) ended in 1943 (with the introduction of penicillin)
e) is still going on

2. The first person to see the Cholera bacillus was

a) John Snow
b) Louis Pasteur
c) Alexander Yersin
d) Robert Koch
e) Johannes Petenkofer

3. People who drank water from the Broad Street Pump in August and September 1854

a) were the only ones who got Cholera in those months
b) were 10-20 times less likely to get Cholera than those who drank water from the Water Company pipes
c) were even less likely to get Cholera than other residents of Altona and more than 20 times less likely than those who drank from the New Street pump in Hamburg
d) were found to be immune to Cholera

4. The causative agent of Cholera is a bacterium in the genus

a) Vibrio
b) Mycobacterium
c) Yersinia
d) Salmonella
e) Treponema

5. The initial infections that led to the Cholera outbreak in Hamburg in 1892 probably arrived

a) by ship from New York City
b) by river barge from Hanseatic traders
c) by train from the Ukraine
d) by naval warships returning from the Crimea
e) in unwashed vegetables from the neighboring town of Altona

6. In underdeveloped regions of the world, antibiotics are not available and hence not used in the treatment of Cholera. The result of this absence of antibiotics is

a) a mortality greater than 40% and sometimes approaching 90%
b) a doubling in the time needed for recovery from 2-3 days to 4-6 days
c) a stronger and longer-lasting immune response against the Cholera bacillus
d) an increased prevalence of Tuberculosis following the weakness brought on by Cholera
e) minimal because antibiotics are ineffective against the Cholera bacillus

7. The main cause of death for Cholera patients is

a) growth of bacteria in the bloodstream and tissues
b) accumulation of bacteria in the lymph nodes
c) dehydration
d) high fever
e) suffocation from fluid in the lungs

8. Normally you have to swallow about a billion Vibrio cholerae cells to get cholera. But if you first take antacids, you only need about a hundred thousand to get cholera. This suggests strongly that

a) antacids do not prevent diarrhea
b) antacids are powerful antibiotics
c) stomach acid is a protective barrier against cholera
d) the “normal” germs in your stomach are killed by the antacids and make room for the cholera germs
e) antacids weaken the immune response and leave you open to many infections, but especially sensitive to cholera

9. Cholera toxin poisons the body by causing the cells of the intestine to dump salt into the small intestine. As a result

a) the salt makes you thirsty and you drink so much fluid that you essentially drown
b) the salt is lost through excretion and you die from lack of sodium chloride
c) the salt dries all the “essential” bacteria that live in the gut and you get very weak because you become “germ free”
d) the resulting salt water in the gut is poisonous
e) the salt draws water from the cells to the gut and you die from loss of water

10. Rehydration is and effective therapy for treating

a) cholera
b) tuberculosis
c) influenza
d) bubonic plague
e) kuru

11. A person who believes in the miasma theory of cholera would argue that

a) boiling all drinking water would protect against cholera
b) there is no protection against cholera because it is an inherited disease
c) building one’s house on a hill would protect against cholera
d) a diet rich in green vegetables and red meat would protect against cholera
e) treatment with purgatives and laxatives would protect against cholera

12. John Snow is the person who

a) was the first to isolate and grow Mycobacterium tuberculosis
b) isolated influenza infected tissue from an obese woman buried in the permafrost in Brevig Mission, Alaska
c) invented the “acid-fast stain” for Mycobacterium tuberculosis
d) was the first to isolate and grow Vibrio cholerae
e) was the first to show that the infectious agent of cholera is carried in the drinking water

13. The bacterium that causes cholera causes the pathological effects of cholera because

a) It induces a high fever
b) It secretes a toxic protein (toxin)
c) It kills phagocytes
d) It multiplies in vesicles inside phagocytes
e) It causes an overreaction from the immune response

14. Antacids reduce the number of cholera germ needed to cause cholera (by 10,000 fold!) because

a) The cholera germs are easily killed by stomach acid
b) The cholera germs are more likely to be successful in causing cholera if the person has an ulcer
c) Cholera germs require high levels of calcium or magnesium for survival
d) In the third world, antacids are taken with water that is often contaminated
e) Antacids are made from the shells of crabs and shrimp-like sea creatures

15. Because of John Snow’s discoveries

a) Many people are vaccinated against tuberculosis with a vaccine of variable effectiveness
b) We are beginning to understand the genetic basis of the influenza pandemic of 1918-19
c) We know that the amyloid plaque found in kuru is different from that seen in Alzheimer’s disease
d) Most large cities began filtering their water
e) Chopin was forced to leave the island of Majorca because of his tuberculosis

16. What usually causes the death of a cholera victim?

a) Secondary bacterial pneumonia
b) Weakening of the immune response
c) Loss of fluid (water) from the body
d) Starvation due to inability to swallow
e) Septicemia (growth of bacteria in the blood)